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Some people who have Medicare also receive Medicaid. And some receive receive Medicaid QMB, which pays the Medicare premium and (I'm told) contributes to help pay for Med-D. But the QMB status means that Medicaid will not pay any portion of the 20% not covered by Medicare, and it bars the purchase of a Med-sup policy.
So, when the bills come in you contact the various doctors, clinics, vendors and explain your situation and beg their patience while you send what you can over a period of time. Most are understanding, some aren't. Those who accept the small incremental payments sometimes write off a portion of the bill. And paying $5 or $10 per month can take a long time to pay off the total amount.
One of those vendors just offered to 'settle' the remaining $2500 debt for around $700. If I had an extra $700 I'd take them up on it; but even if that were to happen, the remainder of the debt would still show up in my credit report as 'unpaid.' And that, by the way, makes it oh so special when a used car salesman laughs and shakes his head 'no' while he walks away to talk to a more likely customer.
Yes, our present health care system has many negatives, including the unintended impacts.
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